桂枝汤加味治疗气血不和型儿童白癜风及对自身免疫的调节

发布时间：2018-05-29 16:30

本文选题：白癜风 + 儿童　；参考：《中国实验方剂学杂志》2017年22期

【摘要】：目的:观察桂枝汤加味治疗气血不和型儿童白癜风的临床疗效及对T淋巴细胞亚群、免疫球蛋白和补体的影响。方法:将134例符合要求的患儿,采用SAS软件生成,随机按数字表法分为观察组与对照组各67例。对照组采用0.03%他克莫司软膏,适量外涂,2次/d。观察组在对照组治疗的基础上服用桂枝汤加味,1剂/d。两组疗程均连续治疗3个月。进行治疗前后白癜风面积评分指数(VASI),黑素指数(MCI),皮肤病生活质量(DIQL)调查量表和气血不和证评分,并评估复色情况;检测治疗前后T淋巴细胞亚群(CD3+,CD4+,CD8+,CD4+/CD8+),补体(C3,C4)和免疫球蛋白(Ig G,Ig M,Ig A)水平。结果:观察组临床疗效总有效率为84.13%,高于对照组的63.49%(χ2=6.938,P0.01);治疗后观察组VASI指数低于对照组(P0.01),DIQL和气血不和证评分均低于对照组(P0.01),MCI指数高于对照组(P0.01);观察组患儿复色率(62.83±11.47)%高于对照组的(53.78±10.29)%(P0.01);与健康对照组比较,白癜风患儿外周血免疫球蛋白Ig G,Ig A水平均明显下降,白癜风患儿外周血T淋巴细胞亚群CD3+,CD4+,CD4+/CD8+水平均有下降,CD8+水平升高(P0.01);Ig M,C3和C4水平差异均无统计学意义;治疗后观察组患儿治疗后Ig G,Ig A水平均显著升高(P0.01),并高于同期对照组(P0.01),Ig M,C3和C4水平变化均无统计学意义;观察组患儿CD3+,CD4+,CD4+/CD8+均较治疗前升高(P0.01),并高于治疗后对照组水平(P0.05);CD8+下降,并低于治疗后对照组水平(P0.05)。结论:桂枝汤加味治疗气血不和型儿童白癜风,能缩小皮损面积,增加白斑黑素含量,提高复色率,改善了患儿生活质量,有明显的临床疗效,其作用机制可能与调节自身免疫失衡有关,值得临床进一步的研究。
[Abstract]:Objective: to observe the clinical effect of Guizhi decoction on vitiligo of children with qi and blood disharmony and its effect on T lymphocyte subsets, immunoglobulin and complement. Methods: 134 children who met the requirement were randomly divided into observation group and control group by SAS software. The control group was treated with 0.03% tacrolimus ointment. Observation group on the basis of the control group on the basis of Guizhi decoction added 1 dose / d. The two groups were treated continuously for 3 months. Before and after treatment, vitiligo area score index (VASI), melanin index (MCI), quality of life of skin diseases (DQL) scale and Qi-blood disharmony syndrome score were evaluated. Before and after treatment, the levels of T lymphocyte subsets (CD3, CD 4, CD 8, CD 4 / CD 8, complement C 3, C 4) and immunoglobulin G G (G G) were measured before and after treatment. Results: the total effective rate of clinical efficacy in the observation group was 84.13, which was higher than that in the control group (蠂 ~ 2 = 6.938, P 0.01), the VASI index in the observation group was lower than that in the control group (P 0.01) and the score of qi and blood disharmony syndrome was lower than that in the control group (P 0.01), and the color repetition rate in the observation group was 62.83 卤11.47%. It was higher than that of the control group (53.78 卤10.29) and compared with the healthy control group. In vitiligo children, the levels of immunoglobulin Ig GG Ig A in peripheral blood were significantly decreased, and the levels of CD4 / CD8 of T lymphocyte subsets in peripheral blood of patients with vitiligo were all decreased, and the levels of CD8 were increased. There was no significant difference in the levels of C _ 3 and C _ 4 between the two groups. After treatment, the levels of Ig GG and Ig A in the observation group were significantly higher than those in the control group (P 0.01), and there was no significant difference in the levels of C 3 and C 4 between the observation group and the control group. The CD4 / CD8 ratio of CD3 in the observation group was higher than that before treatment, and higher than that in the control group after treatment. It was also lower than that in the control group and was lower than that in the control group after treatment. Conclusion: Guizhi decoction can reduce the area of skin lesions, increase the content of melanin, improve the quality of life of children with vitiligo. The mechanism may be related to the regulation of autoimmune imbalance, which deserves further clinical study.
【作者单位】：南方医科大学皮肤病医院;
【基金】：广东省科技计划项目公益研究与能力建设资金专项(2014A020221016)
【分类号】：R275.9

【相似文献】